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The ADHD "Boom": Overdiagnosed, or Finally Understood?

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13.9% of adults in England screen positive for ADHD and 1.8% are diagnosed. Why the rise is recognition, not a fad, and the quality problem inside the boom.

By Dr Hossein Rostamipour, Consultant Psychiatrist and Dr Joseph Rodrigues, Consultant Psychiatrist · Eton ADHD Clinic

Why we have written this. This is for anyone who has read that ADHD is everywhere, that it is a social media fad, that it is being overdiagnosed, and wondered whether that is true. It sets out what the rise in assessments actually consists of, what the best UK data say about how common ADHD is and how many people have been missed, why the surge includes a real problem of quality that deserves to be named, and what a good assessment looks like. It is general information, not personal medical advice.

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You have seen the headlines and heard the chatter online: "ADHD is everywhere." It is true that in recent years there has been a sharp rise in people seeking an ADHD assessment, particularly among adults, women and older people. This has led many to ask whether ADHD is being overdiagnosed, or whether this is a social media fad.

At the Eton ADHD Clinic we see the trend not as an epidemic but as a correction that should have happened a generation ago. For decades the understanding of ADHD was narrow and built on a stereotype, the hyperactive young boy, and as a result whole groups of people were missed. The "boom" is not a new wave of disorder. It is a wave of long-delayed recognition, and the numbers show it.

What the numbers actually say

The best estimate of how common ADHD is, and the one the government's Independent Review adopted in October 2026 with appropriate caution, is around 3 to 4 per cent of the population. That figure is not the problem. The problem is that for decades the proportion actually diagnosed was a small fraction of it. In 2000, 0.26 per cent of 12 to 17 year olds in England had a recorded ADHD diagnosis, against a population estimate of around 3 per cent; by 2025 the figure was 3.88 per cent. The rise since is recognition closing that gap, and it has closed fastest in exactly the groups that were being missed. Three things changed in 2013, when the current diagnostic manual was published: ADHD and autism could be diagnosed together for the first time; the age by which symptoms must have appeared moved from 7 to 12, which brought in the inattentive children who only struggle once secondary school demands organisation; and the number of symptoms an adult needs fell from six to five, reflecting the way hyperactivity turns into restlessness with age. None of that loosened the standard. It redrew the boundary of who the condition describes, while services, training and public understanding stayed where they were.

The population data have caught up. The Adult Psychiatric Morbidity Survey, which has asked a representative sample of adults in England the same six screening questions three times, found the proportion screening positive rose from 8.2 per cent in 2007 to 13.9 per cent in 2023/24, and to 25 per cent among 16 to 24 year olds. Only 1.8 per cent of adults reported a diagnosis. Among those who screened positive, fewer than one in ten had been diagnosed, and six in ten were receiving no mental health treatment of any kind. NHS England's own estimate is that 2.48 million people in England have ADHD, diagnosed or not. A 2026 analysis of English primary care records across a quarter of a century documents the rise in recorded diagnoses in children and adults, and the government's independent review found that while referrals have soared, the underlying prevalence of symptoms in the population has stayed broadly stable.

A positive screen is not a diagnosis. But a gap between 13.9 per cent and 1.8 per cent is not overdiagnosis. It is the opposite.

Why the overdiagnosis narrative does harm

The government's Independent Review, published in October 2026, states that it "cannot conclude that overdiagnosis is occurring at scale", and that the evidence does not show people presenting today are less impaired than those who presented before. When public authorities and some clinicians nonetheless treat the people now being diagnosed as a fad rather than as the missing majority, the consequences are concrete.

It fuels stigma. The narrative tells adults who have spent a lifetime masking their difficulties that they are jumping on a bandwagon. It adds guilt to the exhaustion and keeps people from seeking help.

It underfunds services. If the need is believed to be a fraction of the real need, services are sized for a fraction. The independent ADHD Taskforce found waits of up to four years for children and eight for adults, with some areas reporting ten to fifteen, and only 15 to 25 per cent of people with ADHD obtaining medication. In June 2026 there were up to 959,662 open referrals in England that may be for an ADHD assessment.

It costs the economy. The Taskforce put the cost of untreated ADHD at around £17 billion a year and found that 20 to 34 per cent of young people not in education, employment or training are likely to have it. The Health Foundation's 2026 analysis found that young people with mental health conditions are now more likely to be NEET than their peers, and a cohort study following 8,374 young people found adolescent mental health among the strongest predictors of being NEET at 23. All of that sits inside the Centre for Mental Health's estimate that mental ill health costs England £300 billion a year.

It mislabels people. Without a proper framework, a child's impulsivity is "naughty" and an adult's executive dysfunction is "laziness" or "anxiety". The blame moves from neurobiology to personal failing, and the treatment that would have helped never arrives.

The groups who were missed

Women. The diagnostic picture was built on hyperactive boys. Women, who more often have the inattentive presentation and who mask, were and still are routinely diagnosed with anxiety or depression first. Women now screen positive more often than men, at 14.9 against 12.4 per cent. There is also a hormonal dimension that older models ignored: ADHD symptoms and medication response change across the menstrual cycle, after childbirth and through perimenopause, and a service that does not ask about hormones is treating half the picture. Our women's team integrates that, including PMDD and menopause, with ADHD care.

Autistic people. Until 2013 the rules forbade diagnosing ADHD in an autistic person, so a generation got one label and half an explanation. Around 38 per cent of autistic people meet criteria for ADHD, and a comprehensive ADHD assessment now has to screen for autism, not to issue a second diagnosis on the spot but to understand the whole person, because sensory processing, social style and cognition all change how ADHD presents and what helps. The parallel is exact: in English primary care records, 2.94 per cent of children aged 10 to 14 have a recorded autism diagnosis against 0.02 per cent of adults over 70, and the authors estimated that between 435,700 and 1.2 million autistic people in England are undiagnosed.

Older adults. Many have lived a whole life feeling different without knowing why. Diagnosis at sixty or seventy brings validation and practical help, and it needs a clinician who can tell lifelong ADHD apart from the early signs of dementia, which is why our memory and brain health service sits in the same team.

The real problem inside the boom

Honesty requires saying this plainly: the surge has created a market, and not all of it is good. The Centre for Health and the Public Interest reported in 2026 that NHS spending on private ADHD providers rose 252 per cent in three years, that 32 integrated care boards were £164 million overspent on ADHD services, that some providers had delivered NHS-funded assessments with no contract and some while not registered with the Care Quality Commission, and that there is no mandatory regulation or certified training for assessors. The CQC's State of Care report raises the same concerns about quality and waits.

That is a real problem, and it is the opposite of the overdiagnosis argument. The answer to a bad assessment is not fewer assessments; it is a proper one. A diagnosis made in a forty-minute video call from a questionnaire score, with no developmental history, no informant, no screening for the conditions that mimic ADHD and no follow-up, is not overdiagnosis. It is poor diagnosis, and it costs the NHS twice: once for the assessment and again when the person is re-assessed or treated for the wrong thing. We have written separately about what a proper assessment involves and why no scan, EEG or genetic test can replace it.

What a proper ADHD assessment looks like

Meeting this demand properly means abandoning the cold, intimidating checklist and replacing it with something more rigorous and more humane at the same time.

A conversation, not an interrogation. We see the assessment as collaborative. You should arrive prepared, be understood, and leave empowered whatever the outcome. In practice: forms left incomplete are not held against you, because executive dysfunction is the thing being assessed; the notes you bring are welcomed and used; and the criteria are explained at the start, because we are looking for a pattern of symptoms from childhood, in more than one area of life, not better explained by something else, and you are entitled to know that.

Thorough, because thoroughness is what protects you. A structured diagnostic interview, validated rating scales, a developmental history, information from someone who knew you as a child where possible, screening for autism and for the conditions that mimic ADHD, and physical health checks in line with NICE guidance, including our in-house cardiology where stimulants are being considered.

Strengths as well as difficulties. A good assessment treats ADHD as a dimension of who you are, with real strengths alongside real difficulties, rather than only as a disorder. Our pathway for creative people, led by Dr Obioha Ukaegbu, addresses the common fear that treatment will blunt creativity; in our experience the right support does the opposite, by clearing the mundane tasks that stand between a person and their ideas.

Your journey forward, with or without a diagnosis

An assessment is more than a label; it is an opportunity for self-understanding. If you receive a diagnosis, we treat what follows as a partnership: medication reviewed carefully where it is right, neurodivergent-friendly therapy and coaching, family support, and follow-up every six months rather than discharge at the end of titration, because the evidence is clear that the benefits of treatment appear during treatment, not after a report is written. If you do not receive a diagnosis, our support does not end at the door: we explain what we found instead, offer a formulation of what is going on, and help you find the right next step.

The rise in ADHD assessments is not a sign of a broken system. It is a sign that, as a society, we are finally beginning to listen. The task now is to make sure that what people hear when they come forward is a proper assessment.

How we approach this at the Eton ADHD Clinic

We are a CQC-registered, consultant-led service delivering NHS-commissioned assessments alongside private practice, including under our contract with NHS Wales, with Right to Choose referrals in England. We assess ADHD and autism together, across the lifespan, with the thoroughness described above and the follow-up that turns a diagnosis into an outcome. Children and adolescents are seen in London and in Manchester at Alderley Edge, as well as online.

Six reasons people choose the Eton ADHD Clinic

  1. A CQC-registered, consultant-led assessment of the kind the current market too often lacks.
  2. ADHD and autism assessed together, so the whole person is understood.
  3. Women's ADHD with hormones built in, including PMDD and menopause.
  4. Older adults assessed by clinicians who can tell ADHD from early dementia.
  5. Aftercare that continues, every six months, privately and under our contract with NHS Wales.
  6. Honest about the evidence, including the quality problems inside the boom.

Where to go next

Summary

More people are being assessed for ADHD than ever, particularly adults, women and older people. That is not an epidemic. It is a long-overdue correction: the criteria were widened in 2013, awareness caught up a decade later, and the people being found were always there. In England, 13.9 per cent of adults now screen positive for ADHD and 1.8 per cent have a diagnosis; the gap between those numbers is the "boom". There is a genuine problem inside the surge, which is the quality of some of the assessments being sold, and the answer to it is better assessment, not less.

Sources

Frequently Asked Questions

Is ADHD being overdiagnosed in the UK?

The government's Independent Review states that it cannot conclude overdiagnosis is occurring at scale. In England 13.9 per cent of adults screen positive for ADHD and 1.8 per cent have a diagnosis; among those who screen positive, fewer than one in ten has been diagnosed. Recorded diagnosis in 12 to 17 year olds rose from 0.26 per cent in 2000 to 3.88 per cent in 2025, which is recognition catching up with a population estimate of around 3 to 4 per cent, not running past it.

Why are so many more people being diagnosed now?

Because the diagnostic criteria were widened in 2013 (ADHD and autism can be diagnosed together, the age of onset moved from 7 to 12, adults need five symptoms rather than six) and public awareness caught up a decade later. The people being found, especially women, autistic people and older adults, were always there.

Is the rise in ADHD a social media fad?

Social media has raised awareness, and some of what circulates is wrong, but a positive screen on a validated questionnaire in a national survey is not a TikTok trend. The 13.9 per cent figure comes from the Adult Psychiatric Morbidity Survey, and recorded diagnoses in primary care have been rising for 25 years.

Are some ADHD assessments too quick or poor quality?

Yes, and that is the real problem inside the boom. The Centre for Health and the Public Interest found NHS spending on private ADHD providers up 252 per cent in three years, providers operating without contracts or CQC registration, and no certified training for assessors. The answer is a proper assessment with a developmental history, informant information, screening for mimics and follow-up, not fewer assessments.

Why were women missed?

The criteria were built around hyperactive boys. Women more often have the inattentive presentation, mask their difficulties, and are diagnosed with anxiety or depression first. Women now screen positive more often than men, and hormonal changes across the cycle, after birth and in perimenopause change both symptoms and medication response.

Can you have ADHD and autism?

Yes. Until 2013 the rules forbade the double diagnosis; now around 38 per cent of autistic people are recognised as meeting ADHD criteria. A comprehensive ADHD assessment screens for autism so that the whole person is understood.

Where can I get an ADHD assessment?

Through your GP, who can refer to NHS services or, under Right to Choose in England, to a provider like us; or privately. Contact the Eton ADHD Clinic to begin the conversation. If you are in crisis, call 999 or go to A&E; for urgent help call NHS 111, or Samaritans free on 116 123.

This article was written by Dr. Hossein Rostamipour for Eton Psychiatrists and first published at etonpsychiatrists.co.uk. © 2025 Eton Psychiatrists. All rights reserved.

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